[PP.01.29] ASSESSMENT OF UNCOMPLICATED HYPERTENSION THERAPY EFFECTIVENESS IN REAL LIFE SETTING: HOME BLOOD PRESSURE SELF-MEASUREMENT AS AN ALTERNATIVE TO AMBULATORY 24-HOUR MONITORING

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Abstract

Objective:

Our aim was to compare the home blood pressure (BP) monitoring (HBPM) results with those obtained by ambulatory BP monitoring (ABPM) and office BP measurements before and after 6 month (M) algorithmic antihypertensive treatment of uncomplicated hypertension (UH) in longitudinal real-life BP control program.

Design and method:

We analyzed BP measurement results of 76 consecutively recruited patients (pts) 55,7 ± 9,8 years, with new diagnosed (13,1%) or treated but uncontrolled UH, participants of PERFECT-BP prospective observational study (ISRCTN75706523). Pts were prescribed or switched to perindopril/amlodipine FDC with successively adding, if needed, indapamid-SR, spironolactone, moxonidine or doxasosine. ABPM was performed within 2 days after visit 1 and before visit at M6. A validated oscillometric device Microlife BP3AG1 with individually selected cuff were used for HBPM (three times in the morning and evening for 7 consecutive days after visit 1 and before visit at M6). Office BP measurements were performed with standardized automatic Microlife BPW200 with universal cuff. Pearson's linear correlation was used for analysis.

Results:

By M6 office systolic BP (SBP) lowered from 164,9 ± 1,6 to 134,2 ± 1,3 mmHg; diastolic BP (DBP) – from 98,1 ± 0,9 to 83,2 ± 0,9 mmHg; home SBP – from 146,2 ± 1,6 to 131,6 ± 1,0 mmHg; DBP – from 91,3 ± 1,1 to 82,7 ± 0,8 mmHg; 24-hour SBP – from 150 ± 1,8 to 129,7 ± 1,2 mmHg; DBP - from 91,2 ± 1,2 to 81,4 ± 1,2 mmHg; daytime SBP – from 154,9 ± 2,3 to 134,0 ± 1,7 mmHg; DBP– from 95,3 ± 1,5 to 84,3 ± 1,2 mmHg; (all p < 0,001). HBPM showed a good correlation with office BP measurements and ABPM results at baseline and by M6 both for SBP and DBP (see in table). Masked hypertension at M6 was identified by ABPM in 17 (22,4%) and by HBPM in 19 (25%) pts (p > 0,05).

Conclusions:

HBPM is an acceptable tool for assessment of antihypertensive treatment efficacy for UH in real life setting.

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